| Objective:To analyze the characteristics and risk factors for elderly patients with type 2 diabetes mellitus(T2DM)complicated with heart failure(HF).Methodology: Data of 291 patients with T2 DM complicated with HF were collected from Sichuan Academy of Medical Sciences and Sic huan People’s Hospital from 1st January 2013 to 31 st December 2015.P atients were classified into two groups,according to New York Heart A ssociation(NYHA)functional class.130 patients were assigned to grou p A(NYHAⅠ+Ⅱ)and another 161 patients were assigned to group B(NYHAⅢ+Ⅳ).Clinical data of patients including their ages,genders,courses of diabetes,smoking history,admission blood glucose,glycosyla ted hemoglobin(Hb A1c),blood pressures(SBP,DBP),blood uric acid(U A),estimated glomerular filtration rate(eGFR),serum lipid(TC、TG、L DL-c、HDL-c、Lp(a)),homocysteine(HCY),diabetic complication(various complications represent more than 3 complications)and drug therapies were collected.Statistical analysis methods: Unconditional logistic regres sion mode for simple factors or multi-factors,chi-square test,t test,an d variance analysis were used.All data were analyzed using the SPSS22.0 software package and P < 0.05 was regarded as the level of signifi cance.Results:1.Comparison between two groups:· The mean age,duration of diabetes,HCY and serum UA levels of Group B were all significantly higher than those of Group A.The eGFR level of group B was significantly lower than that of group A.(P< 0.05);Group B has more patients complicated with CKD and coronary heart disease 、various complications than group A does;Group B patients preferred to use insulin more than Group A patients,while Group A patients used more alpha glucosidase inhibitors.There were statistically significant differences between the two groups(P< 0.05).· There was no significant difference(P> 0.05)in gender;smoking history;blood pressure;blood lipid;blood sugar;HbA1c;in complication with hypertension,diabetic vascular disease,DR,DPN,DF;in terms of using metformin,secretagogues,TZD,DPP-4 enzyme inhibitor,GLP-1 receptor agonist;and in the number of patients using antihypertensive drugs between the two groups.2.Correlation analysis:· Single factor Logistic regression analysis showed that age,duration of diabetes,blood UA,HCY,combined with CKD and coronary heart disease、various complications and the use of insulin were positively correlated to the degree of heart failure(P< 0.05);eGFR and the use of alpha glucosidase inhibitors were negatively correlated to the degree of heart failure(P< 0.05).Gender,smoking history,blood pressure,serum lipid,serum glocose,HbA1 c level,hypertension,complications by(diabetic vascular disease,DR,DPN,DF)and uses of metformin,secretagogues and antihypertensive drugs showed no correlation with heart failure exacerbation(P> 0.05).· Non conditional Logistic regression analysis showed that age,duration of diabetes and combined with CKD were independent risk factors of heart failure in elderly patients with T2 DM while the level of eGFR was the negative correlation factor;respective values of OR and 95%CI were as followings,Age,1.038(1.002~1.074);Diabetes course,1.038(1.001~1.077);combined with CKD,2.401(1.391~4.145);and eGFR,0.970(0.960~0.980).Conclusions: Age,duration of diabetes and CKD were independent risk factors of heart failures in elderly patients with T2 DM while the the level of e GFR was the negative correlation factor. |
PDF Full Text Request